Pregnant and parenting young women rarely access community-based smoking cessation interventions. Targeted cessation interventions have been laden with challenges and have produced suboptimal outcomes. There is a paucity of qualitative research specific to young women that explores the context of their tobacco use, as well as their attitudes towards and experiences with smoking cessation supports in pregnancy and postpartum. To bridge this gap, an interpretive descriptive design was used to explore the personal and contextual factors influencing young women’s smoking behaviour during and after pregnancy. Factors were identified by analyzing influences at the multiple levels of McLeroy’s social ecological model of health promotion. Data were collected via in-depth, semi-structured interviews with young women aged 16-24 years (n=13) who smoked regularly preconception and were pregnant or parenting. Transcripts were analyzed using qualitative content analysis. Findings highlighted the complexity and chronicity of issues young women faced and emphasized the interplay of social determinants that influenced their smoking. Smoking was a crutch that helped them to relieve psychological distress stemming from exposure to adverse or traumatic experiences; and persistent stress in the context of socioeconomic hardship, neighborhood disadvantage and limited social support. Smoking also was influenced by young women’s understanding of the harms related to smoking during pregnancy and their reconceptualization of risk for smoking-related consequences postpartum. Young women described having limited discussions regarding smoking with maternity care providers and found their passive approach to cessation counselling unhelpful. They desired more comprehensive cessation support from providers. They expressed interest in a tailored group cessation program and offered suggestions for improving cessation supports for young women in pregnancy and postpartum. Study findings bridge gaps in the literature and identify appropriate next steps in addressing the issue of smoking in pregnancy and postpartum amongst young women by suggesting a multi-level approach to cessation. / Thesis / Master of Science (MSc)

MPH / Department of Public Health / Background: Globally, cigarette smoking is causing preventable deaths in developing countries affecting especially the youth. Historically, cigarette smoking is known to be more common among adults but is also becoming common among students. Purpose: The study aimed to investigate factors contributing to cigarette smoking and its health consequences amongst students of the University of Venda in South Africa. Methodology: A quantitative approach using a descriptive cross- sectional design was adopted. Convenience sampling was used to randomly select 428 respondents. A self-reporting questionnaire with closed ended questions was administered to respondents between the ages of 17-40 years who suited the inclusion criteria. Permission to conduct the research was obtained from the Ethics Committee of the University of Venda. Data were analysed using SPSS version 23 and presented in the form of tables and charts. Pearson’s chi squares were used to test significant relationships between variables and smoking status. Results: A total of 407 students participated in the study. Of the 407, 208 (51%) of respondents were female students. The mean age of the study population was 24 years. Of these 407, 175(43%) reported being smokers 232 (57%) were nonsmokers. More smokers were observed among the male respondents and registered for first and second years. There was a significant relationship between age, gender, religion, school of affiliation, amount of pocket money and smoking status (P-value=0.05).The results showed that the majority of the respondents285 (70%) agreed to the belief that students smoked cigarettes due to availability of cigarettes at every corner of the campus, 281 (79%) peer influenced by friends 289 (71%) family members who smoke, and 313 (76.8%)increase social interaction. The majority of the students were knowledgeable about health consequences caused by smoking. Nonsmoking students were more knowledgeable about harmful effects of smoking as compared to smokers (P=0.00. Conclusion: The study concludes that students smokes cigarettes due to being a friend with someone who smokes, being in new a environment, stress, depression, observation of other students smoking, no signage prohibiting smoking and lack of knowledge regarding health / NRF